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R Wave

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1. ECG R-wave peaks marking with simultaneously recorded continuous blood pressure. (PubMed)

ECG R-wave peaks marking with simultaneously recorded continuous blood pressure. ECG signal is relatively weak and vulnerable to various noise interferences, such as electromyography. There will be robustness problems when detecting the instantaneous heart rate independently. In some cases, multiple human physiologic parameters are monitored to help in heart rate detection.In this paper, an algorithm that marks the R-wave peaks with the help of simultaneously recorded continuous blood pressure

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2019 PLoS ONE

2. Why does this young male with chest pain have a tall R in V1, and lateral Q waves?

Why does this young male with chest pain have a tall R in V1, and lateral Q waves? Dr. Smith's ECG Blog: Why does this young male with chest pain have a tall R in V1, and lateral Q waves? Wednesday, January 4, 2017 This is another post written by , with some editing by Smith. Ken Grauer, who is truly an ECG guru, also had a hand in the analysis of this ECG. Visit his extremely informative site here: Case A teenage male was brought to the ED with 1 week of a left-sided pleuritic chest pain (...) and cough. He had a modest hypoxia, and a temperature of 99.9. He had no documented cardiac disorders. An ECG was obtained: There is borderline sinus tachycardia. The R waves in V1 are abnormally tall, with R/S ratio greater than 1. There are also deep (though narrow) Q waves in I, aVL, V5, and V6. Why does he have these tall R-waves in right precordial leads and Q-waves in lateral leads? Could he have a previous lateral and posterior myocardial infarction (now classified as inferobasal)? Several

2017 Dr Smith's ECG Blog

3. Patient presentation is important, and so is R-wave amplitude

Patient presentation is important, and so is R-wave amplitude Dr. Smith's ECG Blog: Patient presentation is important, and so is R-wave amplitude Wednesday, June 21, 2017 Two Histories, One ECG Story number one: An athletic 20-something presents with chest pain and has this ECG at triage: QTc = 362 ms What do you think? In a 20-something, this is a tough ECG. Is it anterior MI? Being young does not rule it out: There is sinus bradycardia at a rate of 44. There is 2 mm of ST elevation in V2 (...) a wraparound LAD. There is also an upright T-wave in V1, larger than V6. This is a very soft sign of LAD occlusion, and did not add any diagnostic improvement over our formula model for diagnosing LAD occlusion vs. early repol. In that study, this finding was present in 39% of LAD occlusion and 15% of early repol. What do the formulas have to add? Computerized QTc RAV4 = R-wave amplitude in lead V4 STE60V3 = ST Elevation relative to the PQ jct at 60 ms after the J-point QRSV2 = total QRS amplitude (Q, R

2017 Dr Smith's ECG Blog

4. Takotsubo cardiomyopathy and giant r wave syndrome mimicking acute myocardial infarction: A case report. (PubMed)

Takotsubo cardiomyopathy and giant r wave syndrome mimicking acute myocardial infarction: A case report. The clinical features of Takotsubo cardiomyopathy largely overlap with those of acute myocardial infarction, especially in the presence of ST-segment elevation on the initial electrocardiogram. Giant R wave syndrome has mainly been observed in the hyperacute phase of acute myocardial infarction.In this study, we report a unique case of Takotsubo cardiomyopathy that caused giant R wave (...) had decreased markedly. However, on day 3, an electrocardiogram of the V1-V6 leads revealed the formation of giant R wave syndrome: giant R waves merging with the markedly elevated ST segments and the obliteration of S waves. Cardiac echocardiography showed hypokinetic apical mid-segments and hyperkinetic basal segments of the left ventricle, low left ventricular ejection (42%), and enlargement of the left ventricle. On the basis of these findings, the patient was diagnosed with early recurrent

2019 Medicine

5. Risk stratification in hypertension: NT-proBNP and R wave in aVL lead combination better than echocardiographic left ventricular mass. (PubMed)

Risk stratification in hypertension: NT-proBNP and R wave in aVL lead combination better than echocardiographic left ventricular mass. Plasma N-terminal pro brain natriuretic peptide (NT-proBNP) and R wave in aVL lead (RaVL) have been associated with mortality in hypertension. The aim of the current study was to compare the prognostic value of their combination to that of the left ventricular mass index (LVMI) assessed by echocardiography.A total of 1104 hypertensive patients who had

2019 Journal of Hypertension

6. R-Wave Modified Tissue Doppler Imaging Myocardial Performance Index for the Assessment of Cardiac Function in Children with Congestive Heart Failure: A Feasibility Study (PubMed)

R-Wave Modified Tissue Doppler Imaging Myocardial Performance Index for the Assessment of Cardiac Function in Children with Congestive Heart Failure: A Feasibility Study BACKGROUND The aim of this study was to evaluate the feasibility of an R-wave modified tissue Doppler imaging (TDI) myocardial performance index (MPI), or MPI TDI-R, for the assessment of cardiac function in children with congestive heart failure (CHF). MATERIAL AND METHODS Forty children with CHF and 40 normal children were (...) evaluated using the modified pediatric Ross heart failure grading system. TDI recorded the spectrum of diastolic function at the mitral valve annulus to measure the MPI. Twelve-lead electrocardiogram (ECG) measured the R-wave in the QRS complex, resulting in the modified MPI TDI-R. Correlation between the MPI TDI-R, other echocardiographic indices, and the Ross heart failure grades were analyzed, with reproducibility analysis. RESULTS Compared with normal children, the MPI TDI and MPI TDI-R were

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2018 Medical science monitor : international medical journal of experimental and clinical research

7. The Significance of Crochetage on the R wave of an Electrocardiogram for the Early Diagnosis of Pediatric Secundum Atrial Septal Defect. (PubMed)

The Significance of Crochetage on the R wave of an Electrocardiogram for the Early Diagnosis of Pediatric Secundum Atrial Septal Defect. The purpose of this study was to test the hypothesis that the incidence of crochetage on the R wave in inferior limb leads can be used for the diagnosis of pediatric secundum atrial septal defect (ASD). Two hundred fifty-six children with secundum ASD (case cohort) and 256 age- and gender-matched children without heart disease (control cohort) were included (...) in the study. Statistical analyses were performed to test the relationship between the ASD and the crochetage on the R wave with a single lead and three leads, respectively. The impact of incomplete right bundle branch block (IRBBB) and ASD diameter (≥ 5 and < 5 mm) on ASD diagnosis were also explored. Crochetage on the R wave was observed in all three inferior limb leads on 28.13% (72/256, 28 with IRBBB) of subjects with secundum ASD, while it was seen in only 2.73% (7/256, one with IRBBB) of control

2018 Pediatric Cardiology

8. Change in R wave in lead V1 predicts survival of patients with pulmonary arterial hypertension (PubMed)

Change in R wave in lead V1 predicts survival of patients with pulmonary arterial hypertension Clinical guidelines for pulmonary hypertension recommend evaluating treatment response through various methods; however, electrocardiography (ECG) is not included as one of the methods of choice. We aimed to identify ECG parameters that correlated with prognosis in patients with pulmonary arterial hypertension (PAH). A total of 112 consecutive patients with PAH were enrolled in this study. Among them (...) , 83 with treatment escalation were studied for further analysis. Survival analyses were conducted using the Kaplan-Meier method with the log-rank test. Cox proportional hazards regression modeling was used to identify predictors of survival. Receiver operating characteristic analysis was used to determine cut-off values for selected variables. ECG parameters were changed from baseline to three months after treatment. Patients in whom the R wave amplitude in lead V1 decreased by ≥1 mm (0.1 mV

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2018 Pulmonary circulation

9. Cardiac impact of R-wave triggered irreversible electroporation therapy. (PubMed)

Cardiac impact of R-wave triggered irreversible electroporation therapy. Irreversible electroporation (IRE) is a novel tumor ablative therapy technique, using electric fields to induce apoptosis in target tissues. Whether these electric pulses of high field strength can cause cardiac damage and/or ablation-induced arrhythmias is unclear.The purpose of this study was to systematically evaluate the safety of electrocardiogram (ECG)-gated IRE with regard to cardiac side effects.In all patients, 12

2018 Heart Rhythm

10. Lateral MI Explains the Presence of Prominent R Wave (R ≥ S) in V1. (PubMed)

Lateral MI Explains the Presence of Prominent R Wave (R ≥ S) in V1. It is necessary to clarify if the presence of a prominent R wave in V1, in post-myocardial infarction (MI) patients, is due to the involvement of the posterior wall (currently inferobasal segment) or the lateral wall (as has been demonstrated recently by electrocardiographic contrast-enhanced cardiac magnetic resonance [ECG-CE-CMR] correlations studies).In 155 patients with inferolateral zone MI, as detected by CE-CMR (...) cases, 56 of lateral/inferolateral MI (25/31), 52 of inferior MI (SE 44.6%, SP 96.4%). R ≥ 3 mm criterion: Present in 30 cases: 5 of IM lateral, 23 of inferolateral MI, 2 of inferior MI. Absent in 125 cases, 73 lateral/inferolateral MI (26/47), 52 inferior MI (SE 27.7%, SP 96.4%).The presence of prominent the R wave in V1 is due to the lateral MI and not to the involvement of inferobasal segment of inferior wall (old posterior wall).© 2015 Wiley Periodicals, Inc.

2016 Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc

11. "Tracking Interlead Heterogeneity of R- and T-Wave Morphology to Disclose Latent Risk for Sudden Cardiac Death". (PubMed)

"Tracking Interlead Heterogeneity of R- and T-Wave Morphology to Disclose Latent Risk for Sudden Cardiac Death". Sudden cardiac death (SCD) due primarily to ventricular fibrillation claims 1.5 million lives worldwide each year. In 45%-50% of cases, it is the first manifestation of underlying heart disease. Traditional risk factors including smoking, hypertension, age, sex, as well as depressed left ventricular ejection fraction lack sufficient sensitivity and specificity to forewarn (...) of impending life-threatening arrhythmias. There has been a decades-long search for electrocardiographic (ECG) markers of SCD risk. Several interval-based indices such as QT dispersion and Tpeak-Tend interval held initial promise but ultimately yielded mixed results. Recently, the focus has been on interlead heterogeneity of R- and T-wave morphology. The new approaches have involved advanced analytical tools including vectorcardiographic techniques and second central moment analysis of QRS-aligned

2017 Heart Rhythm

12. Usefulness of the R-Wave Sign as a Predictor for Ventricular Tachyarrhythmia in Patients With Brugada Syndrome. (PubMed)

Usefulness of the R-Wave Sign as a Predictor for Ventricular Tachyarrhythmia in Patients With Brugada Syndrome. Brugada syndrome (BrS) is an autosomal dominant channelopathy which is responsible for a large number of sudden cardiac deaths in young subjects without structural abnormalities. The most challenging step in management of patients with BrS is identifying who is at risk for developing malignant ventricular tachyarrhythmia (VTA). In patients with BrS, conduction delay in the right (...) ventricular outflow tract (RVOT) causes a prominent R wave in lead aVR. This electrocardiographic parameter can be useful to detect these high-risk patients. The goal of this study was to test the significance of R-wave elevation in lead aVR as a predictor for VTA in patients with BrS. In this retrospective study, we included 132 patients with BrS (47 ± 15 years, 65% men) who visited the outpatient clinic for cardiogenetic screening. Patients' medical records were examined for the presence of a positive R

2017 American Journal of Cardiology

13. The PCQP Score for Volume Status of Acutely Ill Patients: Integrating Vascular Pedicle Width, Caval Index, Respiratory Variability of the QRS Complex and R Wave Amplitude (PubMed)

The PCQP Score for Volume Status of Acutely Ill Patients: Integrating Vascular Pedicle Width, Caval Index, Respiratory Variability of the QRS Complex and R Wave Amplitude Techniques for measuring volume status of critically ill patients include invasive, less invasive, or noninvasive ones. The present study aims to assess the accuracy of noninvasive techniques for measuring volume status of critically ill patients.A total of 111 critically ill patients admitted to the emergency department (...) and undergoing central venous catheterization were included in the study. Five parameters were measured including vascular pedicle width (VPW), diameter of inferior vena cava, caval index, respiratory changes in QRS, and P wave amplitude. Patients with risk factors which could decrease the accuracy of central venous pressure (CVP) value were excluded from study. We compared these parameters with static CVP parameter. Finally, based on the afore-mentioned parameters, PCQP role in criteria was designed.In

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2017 Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine

14. Paediatric population neuroimaging and the Generation R Study: the second wave (PubMed)

Paediatric population neuroimaging and the Generation R Study: the second wave Paediatric population neuroimaging is an emerging field that falls at the intersection between developmental neuroscience and epidemiology. A key feature of population neuroimaging studies involves large-scale recruitment that is representative of the general population. One successful approach for population neuroimaging is to embed neuroimaging studies within large epidemiological cohorts. The Generation R Study (...) is a large, prospective population-based birth-cohort in which nearly 10,000 pregnant mothers were recruited between 2002 and 2006 with repeated measurements in the children and their parents over time. Magnetic resonance imaging was included in 2009 with the scanning of 1070 6-to-9-year-old children. The second neuroimaging wave was initiated in April 2013 with a total of 4245 visiting the MRI suite and 4087 9-to-11-year-old children being scanned. The sequences included high-resolution structural MRI

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2017 European journal of epidemiology

15. R-wave synchronised atrial pacing in pediatric patients with postoperative junctional ectopic tachycardia: the atrioventricular interval investigated by computational analysis and clinical evaluation (PubMed)

R-wave synchronised atrial pacing in pediatric patients with postoperative junctional ectopic tachycardia: the atrioventricular interval investigated by computational analysis and clinical evaluation R-wave synchronised atrial pacing is an effective temporary pacing therapy in infants with postoperative junctional ectopic tachycardia. In the technique currently used, adverse short or long intervals between atrial pacing and ventricular sensing (AP-VS) may be observed during routine clinical (...) practice.The aim of the study was to analyse outcomes of R-wave synchronised atrial pacing and the relationship between maximum tracking rates and AP-VS intervals.Calculated AP-VS intervals were compared with those predicted by experienced pediatric cardiologist.A maximum tracking rate (MTR) set 10 bpm higher than the heart rate (HR) may result in undesirable short AP-VS intervals (minimum 83 ms). A MTR set 20 bpm above the HR is the hemodynamically better choice (minimum 96 ms). Effects of either setting

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2017 Biomedical engineering online

16. Transient Giant R Wave as a Marker for Ischemia in Unstable Angina (PubMed)

Transient Giant R Wave as a Marker for Ischemia in Unstable Angina Unstable angina is a clinical diagnosis that may present with or without electrocardiographic changes. The "giant R wave" on electrocardiogram has been reported as a manifestation of acute ischemia; however, it is a rare finding in current clinical practice. We describe a case of a patient with unstable angina and a transient "giant R wave" pattern with a culprit lesion in the right coronary artery.

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2017 Cureus

17. The West Midlands ActiVe lifestyle and healthy Eating in School children (WAVES) study: a cluster randomised controlled trial testing the clinical effectiveness and cost-effectiveness of a multifaceted obesity prevention intervention programme targeted at

The West Midlands ActiVe lifestyle and healthy Eating in School children (WAVES) study: a cluster randomised controlled trial testing the clinical effectiveness and cost-effectiveness of a multifaceted obesity prevention intervention programme targeted at The West Midlands ActiVe lifestyle and healthy Eating in School children (WAVES) study: a cluster randomised controlled trial testing the clinical effectiveness and cost-effectiveness of a multifaceted obesity prevention intervention programme (...) activity in 6- to 7-year-olds did not reduce BMI at 3 or 18 months. {{author}} {{($index , , , , , , , , , , , , , , , , , , , , & . Peymane Adab 1, * , Timothy Barrett 2 , Raj Bhopal 3 , Janet E Cade 4 , Alastair Canaway 5 , Kar Keung Cheng 1 , Joanne Clarke 1 , Amanda Daley 1 , Jonathan Deeks 1 , Joan Duda 6 , Ulf Ekelund 7, 8 , Emma Frew 1 , Paramjit Gill 1 , Tania Griffin 1 , Karla Hemming 1 , Kiya Hurley 1 , Emma R Lancashire 1 , James Martin 1 , Eleanor McGee 9 , Miranda J Pallan 1 , Jayne Parry

2018 NIHR HTA programme

18. What is the clinical effectiveness of extracorporeal Shock Wave Therapy or barbotage in the management of rotator cuff calcific tendinopathy?

What is the clinical effectiveness of extracorporeal Shock Wave Therapy or barbotage in the management of rotator cuff calcific tendinopathy? Getting Evidence into Clinical Practice: Barbotage for calcific cuff tendinopathy Musculoskeletal Research Facilitation Group (CAT Group) Date: 25.7.18 CAT Lead: Emma Salt Date CAT completed: Email: emma.salt@nhs.net Date CAT to be reviewed: 2021 Specific Question: What is the clinical effectiveness of extracorporeal Shock Wave Therapy or barbotage (...) in the management of rotator cuff calcific tendinopathy? Clinical bottom line There is moderate evidence that shock wave therapy and barbotage are safe procedures. There is limited evidence to suggest it is effective for rotator cuff calcific tendinopathy. Of the two interventions, available limited evidence suggests barbotage may be more effective than shockwave. Why is this important? Calcific tendonopathy commonly affects supraspinatus and infraspinatus muscles of the rotator cuff in adults aged 30 to 60

2019 Public Health England

19. Inappropriate subcutaneous implantable cardioverter-defibrillator therapy due to R-wave amplitude variation: Another challenge in device management (PubMed)

Inappropriate subcutaneous implantable cardioverter-defibrillator therapy due to R-wave amplitude variation: Another challenge in device management 28491773 2019 02 26 2214-0271 3 1 2017 Jan HeartRhythm case reports HeartRhythm Case Rep Inappropriate subcutaneous implantable cardioverter-defibrillator therapy due to R-wave amplitude variation: Another challenge in device management. 78-82 10.1016/j.hrcr.2016.09.010 Batul Syeda A SA Cardiology Division, Maimonides Medical Center, Brooklyn, New (...) -0271 Amplitude variation Implantable defibrillators Inappropriate shocks Oversensing QRS-T ratio R-wave amplitude S-ICD screening Slew rate Subcutaneous ICD baseline shift signal classification 2017 5 12 6 0 2017 5 12 6 0 2017 5 12 6 1 epublish 28491773 10.1016/j.hrcr.2016.09.010 S2214-0271(16)30115-4 PMC5420026 J Am Coll Cardiol. 2014 Apr 22;63(15):1473-9 24530663 J Cardiovasc Electrophysiol. 2015 Apr;26(4):417-23 25581303 Heart Rhythm. 2014 Aug;11(8):1352-8 24732366 J Am Coll Cardiol. 2012 Nov

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2016 HeartRhythm Case Reports

20. R-wave peak time at lead II in Chinese healthy adults. (PubMed)

R-wave peak time at lead II in Chinese healthy adults. Wide QRS complex tachycardia (WCT) is a common arrhythmia. How to differentiate between WCTs is a challenge in clinical practice. Recently R-wave peak time (RWPT) at lead II was reported to be a helpful and simple tool for differentiating WCTs. However, it has remained unknown about the reference range of RWPT at lead II. In present study, we aimed to investigate the reference range of RWPT at lead II in Chinese healthy adults.A

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2016 BMC Cardiovascular Disorders

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